have been described previously,1-9 there still remains some controversy concerning the incidence, pathogenesis, and treatment of the several types of neurologic complications of the disease. Many of the previous publications of the neurologic aspects of myelomatosis were based on observations of small series of patients who were sometimes specially selected (eg, those admitted to a neurosurgical service). The emphasis of many of the previous reports has been either on the direct compression of the nervous system by myeloma tumor or on distant "toxic" effects. In the older literature, the criteria for the diagnosis of multiple myeloma have, at times, also been uncertain.The purpose of this communication is to report and discuss the neurologic complications observed in 277 patients admitted to a general hospital, where a diagnosis of multiple myeloma was eventually proved.
Materials and MethodsThe 277 patients were all studied at The Mount Sinai Hospital, New York. The clinical and labora¬ tory features of some 90 of these patients were collected in a monograph ten years ago.8 A few others have also been previously reported.8"11 For inclusion in this series all patients satisfied at least two of the following criteria for the diagnosis of myelomatosis: (1) histologie (biopsy or autopsy) proof of the disease; (2) bone marrow obtained by aspiration, showing more than 15% plasma cells ;(3) a homogeneous protein spike in serum or urine electrophoresis ; (4) Bence Jones proteinuria ; and (5) characteristic abnormalities on roentgenograms of the skull and other bones. The last three criteria were accepted only if another disease (eg, macroglobulinemia, leukemia, metastatic carcinoma) was excluded. Seven patients with a solitary plasmacytoma have been included, although not all could be followed until their disease became generalized.The neurologic data were obtained by reviewing clinical records, autopsy protocols, operative notes, myelograms, and other available studies. For con-
